AMA Journal calls for change in how hospitals handle and disclose the practice of overlapping surgeries

Recently I wrote a blog post about how Virginia Mason recently decided to disclose to their patients the practice of overlapping surgeries, including revising their informed consent process to make more clear that the practice occurred and how that might affect the patient.

One area of concern with the new Virginia Mason disclosure was that patients were being told that their surgeon would always been in the operating room for “critical portions” of the surgery, but that term was not defined.

Now the American Medical Association has published an article calling for reforms regarding this practice and disclosing it to surgical patients. It too finds fault in hospitals who allow their surgeons to decide which portions of the surgery were critical. Some surgeons believe that, in certain spine surgeries, there are no “crucial portions”, so the attending surgeon theoretically would never have to be in the OR.

Instead of this practice, the AMA article suggests that a committee within the hospital, and not just the particular surgeon, should define the “critical portion” of a given surgery. Additionally, the article suggests that there should be some method of tracking when a surgeon is physically in an OR.

The article points out that little is known on the subject of whether the common practice of overlapping surgeries actually impacts patient safety. Without that research, it’s impossible to say whether the above steps will have any effect on patient safety. However, at a minimum I hope that greater transparency about the practice will allay public fears.